Surgical Mask vs FFP3 vs N95 vs Respirator - A Medical Professional Weighs In
Dr. Peter is no stranger to face masks. He regularly wears them during patient appointments at his pediatric dental practice in Arlington, VA. For the last few months during this COVID-19 pandemic, he's been wearing a face mask in public too. Unfortunately, It's very difficult to understand the quality, construction, and protection that masks provide without a medical or scientific background. Keep reading to learn more than you'll ever want to know about the different options and different protection levels masks offer.
The first and more important definition we need to understand is the difference between a mask and a respirator. When we talk mask to protect against COVID-19, we are actually talking about a respirator.
These are designed primarily for one way protection (to capture bodily fluid leaving the wearer - in case of cough, sneeze, etc).
Primary design is NOT to protect the wearer.
Most do not have a safety rating.
Generally looser fitting and made of 2-3 ply with a melt blown layer in-between.
Tight fitting with a much better face seal.
Designed to provide two way protection (non-valve) but filtering both the outward and inward air.
Generally have stricter testing and safety ratings depending on how much they protect the wearer
The US Center for Disease Control (CDC) has stated the N95 respirator as the standard and advised personal protective equipment in their Covid-19 and SARS guidance. It is recommended to use at least an n95 or better for protection against respiratory viruses such as the two above. CDC FAQ.
N95, FFP3, FFP2:
The American Standard of respirator protection is managed by the NIOSH (part of the CDC) and the most commonly known respirator is the n95. Europe uses two different standards which include the FFP (filtering face piece) and P1/P2/P3 ratings. Both are managed by the CEN (European Committee for Standardization).
FFP1 filters at least 80% of particles that are 0.3 microns in diameter or larger.
FFP2 filters at least 94% of particles that are 0.3 microns in diameter or larger.
N95 filters at least 95% of particles that are 0.3 microns in diameter or larger.
N99 & FFP3 filters at least 99% of particles that are 0.3 microns in diameter or larger.
So what does that mean for protection? The closest European equivalent to the n95 is the FFP2 respirator, which is rated at 94%
What about KN95s?
The Chinese standard of N95 that is supposed to have an equivalent specification to n95/FFP2 respirators. According to 3M: "It is reasonable to consider the Chinese KN95 as equivalent to the US N95 NIOSH respirators." The problem is there have been quite a few quality control issues with the KN95 respirators and the surge in demand has created a shortage. KN95 respirators generally use ear loops rather than behind head elastics which has a worse seal and there is no guarantee the mask you are receiving is actually meeting the Chinese standard: Counterfeit Respirators. Although it's safe to say KN95's will most likely do a better job of filtration than a t-shirt face covering, it's hard to know exactly how effective they are (especially if you are using a counterfeit model).
Valve Vs Non-Valve Respirators
Respirators with valves make it much easier to exhale air and makes them more comfortable to wear. The valve can also lead to less moisture build up inside the respirator but they do NOT filter the wearer's exhalation. This provides one way protection for the wearer but puts others at risk in situations like Covid-19. You'll never see these respirators used at hospitals or surgical centers because of this. With the shortage, it's possible this is the only kind of mask you're able to find, and if that's the case, you can place a surgical mask or face covering over the valve to partially filter the out breath.
What is a P95 Respirator?
In the USA, there are 3 ratings for protection against oils, N, R, or P. Although all of these masks filter the same, they have differing resistance to oil and are useful for different settings (usually industrial).
N - Not resistant to oil
R - somewhat resistant to oil
P - strongly resistant to oil (Oil Proof)
When working in an industrial setting, there may be oil particles in the air and this distinction is very important. If the mask does not carry a R or P rating, the oil may degrade and reduce the filtering capacity and performance of the respirator. For the vast majority of people trying to protect against Covid-19 or other respiratory viruses, any of these masks will be sufficient.
Are there any good sources for N95s or KN95s?
Right now, the US government and FEMA have reduced a lot of suppliers capacity to provide N95 and KN95 masks to the general public and are limiting shipments to medical personnel and hospitals only.
Two of our recommendations that are currently in stock and approved to at least ffp2 are the Health Body Guard (shipping from Ohio for $4 a mask):
U-Mask (international shipping, reusable to interchangeable filters) :
We have no affiliation with either of these options.
What about homemade masks?
The CDC gave guidance on citizens using cloth or face coverings when in public if social distancing measures are difficult to obtain. Although shortages have become less widespread for surgical masks (N95's are still reserved for healthcare and frontline workers), there are some things to consider such as materials when making your own mask.
image via smartairfilters.com
image via smartairfilters.com
It's important to note the differences in how various household mask materials compare in terms of effectiveness against particles. A study done by Cambridge University found the pillowcase and the 100% cotton t-shirt were the most suitable materials for an improvised face mask or face cover. Although certain materials such as a vacuum bag did have better filtration, they were very bad for breathability and thus, not recommended.
Here is a video from the US Surgeon General on how to make your own mask:
Hopefully we've been able to provide you with enough information to clarify the difference between N95, KN95, FFP2/3, and surgical masks. If you have any further questions, do not hesitate to reach out to Dr. Peter at firstname.lastname@example.org.
VK Pediatric Dentistry
5001 Lee Hwy, Arlington VA 22207
Schedule An Appointment Today in Arlington, Virginia at VK Pediatric Dentistry
If you haven't taken your child to a pediatric dentist yet or would like to schedule an appointment, Dr. Peter and the highly skilled team at VK Pediatric Dentistry are just a phone call away. Schedule an appointment online or call us today at 703-962-7814. We look forward to providing your children a lifetime of healthy and happy smiles!